CCO Legislation Demanding More Accountability Passes in House

Five Democrats opposed the bill, while two Republicans supported the measure -- Rep. Julie Parrish of West Linn and Rep. Jeff Helfrich of Hood River. Chances of passage in the Senate may be narrower.

Legislation to increase transparency and accountability for coordinated care organizations has passed the Oregon House of Representatives on a narrow 32-26 vote, with five Democrats joining all but two Republicans present in opposition.

“It adds transparency and requires CCOs to reinvest in their community,” said Rep. Andrea Salinas, D-Lake Oswego. “It allows for greater community membership on CCO boards.”

HB 4018 now heads to the Senate, where Health Committee Chairwoman Laurie Monnes Anderson, D-Gresham, has been less committal about the CCO reforms from the House. She said before the session that she wanted to follow the lead of the Oregon Health Policy Board in charting the future of the CCOs.

House Bill 4018 pries open the doors of the board meetings for the state’s 15 CCOs, requiring them to meet in public to determine how to spend billions of tax dollars they receive each year to serve nearly one million people with the Oregon Health Plan. If signed into law, the bill would take effect for the next five-year Medicaid managed care contracts next year.

In addition, the bill requires excess financial reserves to be invested in improving community health and requires CCOs to give notice if they plan to end service, hoping to prevent the panic caused by FamilyCare’s abrupt announcement last year that it would close in December, leaving 115,000 Medicaid recipients in the lurch. In that case, FamilyCare agreed to stay open an additional month to reduce the disruption. 

Under HB 4018, CCOs would have to give four months’ notice to the Oregon Health Authority if they did not wish to renew their annual contract, and would have to give three months’ notice to members, along with a plan to transfer their care.

Rep. Mitch Greenlick, D-Portland, modeled the open meetings language after the policy already in place at two CCOs administered by PacificSource, but the Coalition of Healthy Oregon, an alliance of seven for-profit CCOs, remained opposed to a law increasing transparency. The CCOs that are not members of the coalition supported the bill and its new requirements.

COHO and its allies, which spend roughly $700,000 a year on political campaigns, have successfully lobbied to defeat Greenlick’s transparency legislation in past years and may have influenced the five Democrats to oppose the bill, but Republicans staged their floor fight, at least superficially, around making the bill stronger than what was passed.

Rep. Knute Buehler, R-Bend, wanted stricter standards for how the CCOs could use money intended for social determinants of health. “The amount they spend on social determinants varies widely,” he said. “Physical care is a small portion of keeping people healthy.”

“I think it’s time now, not to talk about what could have been or should have been or might have been, but talk about what is in the bill,” Greenlick retorted.

Rep. Cedric Hayden, R-Cottage Grove, wanted to set up a task force to meet publicly to discuss how the state might fill the $1.5 billion budget hole for the Oregon Health Plan in the next biennium.

Hayden’s intention was to avoid the closed-door meetings where Democrats hashed out the current budget with industry lobbyists last spring. Hayden helped force last month’s Measure 101 election, where voters approved the taxes to support the current budget 62-38.

Rep. Julie Parrish, R-West Linn, who was Hayden’s ally in the past year’s fight over the funding plan for Medicaid, voiced support for his amendment on the floor before voting in support of the underlying bill. She was joined by newly appointed Rep. Jeff Helfrich of Hood River as the only two Republicans to support HB 4018.

Reach Chris Gray at [email protected].

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